Abstract
When alveolar preservation procedures are not performed after tooth extraction, aesthetic and functional impairment could occur. Guided bone regeneration using polytetrafluoroethylene (PTFE) membranes has proven to be a simple alternative treatment that results in good maintenance of the alveolar bone for mediate/late implant placement. Therefore, this study compared the effect of alveolar preservation with the use of dense PTFE membranes, with and without xenograft material by Computerized tomography-based body composition (CTBC) analysis, after four months of the socket preservation procedure. A total of 29 teeth indicated for extraction. In the test group, the sockets were filled with bone graft biomaterial and subsequently coated with a dense PTFE membrane. In the control group, the sockets were filled with the blood clots and subsequently coated with a dense PTFE membrane. The results we found on the changes of the bone width and height after the procedures were: buccal plate: control group 0.46 mm, test group 0.91 mm; alveolar height: control group −0.41 mm, test group 0.35 mm; cervical third: control group −0.89 mm, test group −0.11 mm; middle third: control group −0.64, test group −0.50; and apical third: control group 0.09 mm, test group −0.14 mm. The use of a xenograft in conjunction with d-PTFE membranes proved to be superior to the use of the same membrane and blood clot only in regions of the crest, middle third, and alveolar height.
Highlights
Socket preservation after tooth extraction is a constant challenge for clinicians, given the importance of maintaining sufficient bone height and thickness to assist in oral rehabilitation, with or without implants
In the case of expanded PTFE membranes, the pores allow fiber penetration, which requires dissection of the surrounding tissue at the time of removal, whilst dense polytetrafluoroethylene (d-PTFE) membrane removal is simple due to the absence of internal tissue integration into the structure [16]. Another important characteristic of the dense PTFE membranes is the capacity of cellular occlusion, which allows epithelial and bacterial cells exclusion from the healing sites, improving bone regeneration inside the dental sockets, and providing better results with respect to ridge preservation [17,18]
Since it has previously been clearly shown that if nothing is done at the time of tooth extraction, the patient would be subject to an average absorption of 50% of the socket volume [3], we considered that the procedure used for the Test group 1 (TG1) in our study would be of some benefit to the patient
Summary
Socket preservation after tooth extraction is a constant challenge for clinicians, given the importance of maintaining sufficient bone height and thickness to assist in oral rehabilitation, with or without implants. The natural bone remodeling that occurs after an extraction leads to cosmetic and functional defects, and these defects can be so severe that the placement of implants or conventional dentures can be difficult, or even impossible, without the use of some type of grafting procedure [1,2]. This socket resorption refers to the remodeling that occurs after tooth extraction, and it may result in up to 50%. The principles of osteoconductivity provide the space and framework for cell substrate and biochemical events to enable bone formation to occur [5]
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